Tracheostomy Care Procedure
Key Points
- Routine tracheostomy care lowers bacterial entry into the airway and supports tube patency.
- Inner cannula care is performed at least every 12-24 hours, with more frequent care for heavy secretions.
- Dressing should be changed at least once per shift and immediately when wet or soiled.
Equipment
- Tracheostomy care kit per facility standard
- Replacement or cleaning supplies for inner cannula type in use
- Clean tracheostomy dressing materials
- Personal protective equipment
Procedure Steps
- Verify patient status, airway stability, and supplies before starting tracheostomy care.
- Prepare sterile or clean-field materials according to policy and identify whether inner cannula is disposable or reusable.
- Remove and clean/replace the inner cannula first (this limits contamination of the new dressing after cough stimulation).
- Assess stoma and surrounding skin for irritation, moisture, or breakdown.
- Clean flange area and peristomal region using kit components and prescribed method.
- Apply a clean tracheostomy dressing.
- Confirm tube security and reassess airway patency and secretion movement after care.
- Document care time, stoma findings, cannula action (cleaned/replaced), and patient response.
- Repeat care at least every 12-24 hours and increase frequency when secretion burden is high.
Common Errors
- Changing dressing before inner cannula care → newly applied dressing is rapidly soiled by induced coughing.
- Delaying routine cannula maintenance → increased risk of tracheostomy tube obstruction.
- Leaving wet or soiled dressing in place → higher local bacterial burden and skin breakdown risk.
- Incomplete post-care reassessment → delayed recognition of persistent airway compromise.
Related
- tracheostomy-and-tracheostomy-care - Concept-level rationale for routine care intervals and safety priorities.
- respiratory-failure - Common condition requiring prolonged tracheostomy-based airway support.